<!DOCTYPE html>
<html lang="en">
<head>
    <meta charset="UTF-8">
    <title>YY 服装</title>
    <link href="test2_3.css" type="text/css" rel="stylesheet">
</head>
<body>
<div>
    <div class="herder">
        <img src="image/apply_1.gif">
    </div>
    <div class="banner">
        <div class="banner_left">
            <img src="image/apply_2.gif">
        </div>
        <div>
            <h1>YY服装加盟申请表</h1><br>
            <p class="blue">注:打*为选填项</p>
        </div>
    </div>
    <br><br>
    <div>
        <h3>代理申请基本信息</h3><br>
        <div class="main_content">
            <div class="content_left">
                <p>申请人姓名<span class="red">*</span></p>
                <p>籍贯<span class="red">*</span></p>
                <p>性别<span class="red">*</span></p>
                <p>身份证号<span class="red">*</span></p>
                <p>联系地址<span class="red">*</span></p>
                <p>电话<span class="red">*</span></p>
                <p>电子邮箱<span class="red">*</span></p>
                <p>加盟地区<span class="red">*</span></p>
                <p>你是从哪里了解到我们的？</p>
            </div>
            <div class="content_right">
                <input class="text">
                <selct>
                    <option>请选择</option>
                    <option>选项1</option>
                </selct>
                <span class="check_text">省</span>
                <selct>
                    <option>请选择</option>
                    <option>选项1</option>
                </selct>
                <span class="check_text">市</span><br>
                <input type="radio"><span class="radio_text">男</span>
                <input type="radio"><span class="radio_text">女</span>
                <input class="text">
                <input class="text">
                <input class="text">
                <input class="text">
                <input type="checkbox">Baidu
                <input type="checkbox">Google
                <input type="checkbox">电视广告
                <input type="checkbox">报刊杂志
                <input type="checkbox">路牌广告<br>
                <input type="checkbox">朋友介绍<br>
                <input type="checkbox"><span class="red">点击查看“YY服饰”项目网上加盟免责声明</span><a href="">[点击查看]</a> <br>
                <input type="submit">
            </div>
        </div>
    </div>
</div>
</body>
</html>